Differential Diagnosis for Thick Reddish Wax from Ear

• Single most likely diagnosis
  • Cerumen impaction: This is the most common cause of thick, reddish wax from the ear. It occurs when earwax builds up and blocks the ear canal, often causing discomfort, hearing loss, and potentially leading to infection.
• Other Likely diagnoses
  • Otitis externa: An infection of the outer ear canal, which can cause redness, swelling, and discharge that may resemble thick, reddish wax.
  • Eczema or psoriasis of the ear canal: Skin conditions that can lead to inflammation and the production of thick, reddish discharge.
  • Ear canal dermatitis: Inflammation of the skin in the ear canal, which can cause symptoms similar to those of cerumen impaction.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Malignant otitis externa: A severe infection of the outer ear that can spread to surrounding bone and tissue, particularly in diabetic or immunocompromised patients.
  • Middle ear infection (otitis media) with perforation: A bacterial infection of the middle ear that can cause discharge and may lead to serious complications if not treated promptly.
• Rare diagnoses
  • Cholesteatoma: A rare skin cyst in the middle ear that can cause discharge and may lead to serious complications, including hearing loss and neurological problems.
  • Ear canal tumors: Benign or malignant growths in the ear canal, which can cause a variety of symptoms, including discharge and hearing loss.